Clinical and histopathological characteristics of pediatric chronic rhinosinusitis undergoing endoscopic sinus surgery
Main Article Content
Abstract
The study was conducted to describe the clinical, endoscopic, computed tomography (CT), and histopathological characteristics of pediatric chronic rhinosinusitis (CRS) patients requiring surgical treatment. This retrospective and prospective cross-sectional study enrolled 103 patients diagnosed with CRS who underwent endoscopic sinus surgery at the National Hospital of Otolaryngology from January 2021 to March 2026. The mean age was 12.54 ± 2.33 years old. Nasal obstruction and nasal discharge were the most common symptoms. Nasal polyps were present in 88.3% of patients, of whom 61.2% had bilateral polyps. On CT, the mean Lund–Mackay score was 16.36 ± 4.02. Histopathological findings consisted predominantly of inflammatory polyps (49.5%) and edematous polyps (45.6%). Among the 33 cases with eosinophil quantification, 69.7% had an eosinophil density of ≥ 10 cells/high-power field (HPF). Pediatric CRS requiring endoscopic sinus surgery is mainly observed in older children and adolescents and is characterized by a high prevalence of nasal polyps, extensive sinonasal involvement on CT and frequent eosinophilic infiltration in the histologically evaluated cases.
Article Details
Keywords
Pediatric chronic rhinosinusitis, endoscopic sinus surgery, nasal polyps, eosinophils
References
2. Elwany S, El-Dine AN, El-Medany A, Omran A, Mandour Z, El-Salam AA. Relationship between bacteriology of the adenoid core and middle meatus in children with sinusitis. J Laryngol Otol. 2011; 125(3): 279-281. doi:10.1017/S0022215110002586.
3. Zuliani G, Carron M, Gurrola J, et al. Identification of adenoid biofilms in chronic rhinosinusitis. Int J Pediatr Otorhinolaryngol. 2006; 70(9): 1613-1617. doi:10.1016/j.ijporl.2006.05.002.
4. Vlastarakos PV, Fetta M, Segas JV, Maragoudakis P, Nikolopoulos TP. Functional endoscopic sinus surgery improves sinus-related symptoms and quality of life in children with chronic rhinosinusitis: a systematic analysis and meta-analysis of published interventional studies. Clin Pediatr (Phila). 2013; 52(12): 1091-1097. doi:10.1177/0009922813506489.
5. Sethi G, Chakravarti A. Quality of life after endoscopic sinus surgery in refractory pediatric chronic rhinosinusitis. Int J Pediatr Otorhinolaryngol. 2016; 90: 160-164. doi:10.1016/j.ijporl.2016.09.005.
6. Fetta M, Tsilis NS, Segas JV, Nikolopoulos TP, Vlastarakos PV. Functional endoscopic sinus surgery improves the quality of life in children suffering from chronic rhinosinusitis with nasal polyps. Int J Pediatr Otorhinolaryngol. 2017; 100: 145-148. doi:10.1016/j.ijporl.2017.06.007
7. Bothwell MR, Piccirillo JF, Lusk RP, Ridenour BD. Long-term outcome of facial growth after functional endoscopic sinus surgery. Otolaryngol Head Neck Surg. 2002; 126(6): 628-634. doi:10.1067/mhn.2002.125607.
8. Hsieh SF, Wu PW, Chiu CH, Huang YL, Huang CC. Histopathological Characteristics of Nasal Tissues From Paediatric Patients with Chronic Rhinosinusitis and Nasal Polyps Requiring Revision Surgery. J Inflamm Res. 2025; 18: 13279-13289. doi:10.2147/JIR.S540300.
9. Kim D, Ryu G, Hong SD, et al. Clinical Characteristics of Pediatric Chronic Rhinosinusitis: A Nationwide Retrospective Multicenter Study. J Rhinol. 2025; 32(1): 28-35. doi:10.18787/jr.2024.00040.
10. Siedek V, Stelter K, Betz CS, Berghaus A, Leunig A. Functional endoscopic sinus surgery-A retrospective analysis of 115 children and adolescents with chronic rhinosinusitis. Int J Pediatr Otorhinolaryngol. 2009; 73(5): 741-745. doi:10.1016/j.ijporl.2009.01.019.
11. Heath J, Hartzell L, Putt C, Kennedy JL. Chronic Rhinosinusitis in Children: Pathophysiology, Evaluation, and Medical Management. Curr Allergy Asthma Rep. 2018; 18(7): 37. doi:10.1007/s11882-018-0792-8.
12. Wu PW, Chiu CH, Huang YL, et al. Tissue eosinophilia and computed tomography features in paediatric chronic rhinosinusitis with nasal polyps requiring revision surgery. Rhinology. 2023; 61(3): 348-357. doi:10.4193/Rhin22.435.